REJOICE! Performing Arts Studio

Date of Application:____________________________________________________________

Full Name of Student:___________________________________________________________

Age as of September of Current Year:_______________________________________________

Commitment Level of Student: Very High____ High_____ Moderate_______

NOTE: In order to be considered for Scholarship, thoroughly fill out this form and submit to RMPA studio or home office along with 1) RMPA Enrollment Form, and 2) Registration Fee(s) for current year. If scholarship request is denied, all registration fees will be re-funded in full.

**Please note that Scholarship Recipients are required to be exemplary students in area of character (prompt; in correct attire per class; positive attitude; disciplined to do personal best in every class; follow class etiquette rules as stated on "class etiquette" web site stated above). Failure to meet these standards will result in the student being dropped from scholarship status.**

Circle the class(es) and/or lesson(s) requested and write specific class(es) in appropriate Space. Refer to web site for current prices and calculate accordingly below:

1 ½ Hour Dance Class(es): (Specify)______________________________________________________________________

1 Hour Dance Class(es): (Specify)______________________________________________________________________

45 Min. Dance Class(es): (Specify)______________________________________________________________________

CwOC (Compete w/Out Compromise):

(Specify area of Interest)__________________________________________________________

1 Hour Instr. Lesson: (Specify)_____________________________________________________

½ Hour Instr. Lesson (Specify)_____________________________________________________

Amount of Total Cost:___________________________________________________________

Amount Requested for Scholarship:_________________________________________________

******************Office Use Only*********************

_________ Approved Amount Granted:____________________

_________ Denied

Reason:_____________________________________________________________________________________________________________________________________________________

Signature of Parent(s)/Legal Guardian(s) if Under 18 Years Old:

__________________________________________ Date:____________________________

Signature of RMPA Director:

__________________________________________ Date:____________________________